title: Disadvantageous shift in energy balance is primarily expressed in high-quality sleepers after a decline in quality sleep because of disturbance.
abstract: BACKGROUND
  Epidemiologic studies have shown an inverse or U-shaped relation between sleep duration and body mass index (BMI; in kg/m(2)). Moreover, associations between energy balance (EB) and characteristics of quality sleep (QS) have recently been reported.
  
  
  OBJECTIVE
  We assessed the relation between total energy expenditure (TEE) as well as substrate oxidation and QS after disturbed compared with nondisturbed sleep in EB.
  
  
  METHODS
  Fifteen healthy men (mean ± SD BMI: 24.1 ± 1.9; age: 23.7 ± 3.5 y) were included in a randomized crossover study. TEE and substrate oxidation were measured twice for 48 h in a respiration chamber, whereas slow-wave sleep (SWS), rapid eye movement (REM)-sleep, total sleeping time (TST), sleep stage 2 (S2), and QS [(SWS + REM) ÷ TST × 100%] were determined by using electroencephalography. During 2 nights, sleep (2330-0730) was either disturbed or nondisturbed (control).
  
  
  RESULTS
  Positive correlations were shown for TEE, activity-induced energy expenditure corrected for body mass (AEE/BM), respiratory quotient (RQ), and carbohydrate oxidation with QS and SWS during nondisturbed sleep. Fat oxidation was inversely correlated with QS and SWS. RQ and carbohydrate oxidation were inversely related to REM sleep. During the disturbed condition SWS, REM, TST, and S2 were reduced, and positive correlations were shown between TEE and AEE/BM with QS. The reduction in QS was stronger in high-quality sleepers; QS reduction was positively associated with increases in energy intake, TEE, and EB.
  
  
  CONCLUSIONS
  A disadvantageous shift in energy balance is primarily expressed in high-quality sleepers after a decline in QS because of disturbance, implying that good sleepers are most liable to a positive energy balance because of sleep disturbance. This trial was registered at ISRCTN as NTR1919.
authors.affiliation: Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, Maastricht University, Maastricht, Netherlands. rick.hursel@maastrichtuniversity.nl
authors.forename: Rick
authors.initials: R
authors.lastname: Hursel
authors.forename: Hanne K J
authors.initials: HK
authors.lastname: Gonnissen
authors.forename: Femke
authors.initials: F
authors.lastname: Rutters
authors.forename: Eveline A P
authors.initials: EA
authors.lastname: Martens
authors.forename: Margriet S
authors.initials: MS
authors.lastname: Westerterp-Plantenga
mesh_terms: D000328:Adult; D001823:Body Composition; D015992:Body Mass Index; D050260:Carbohydrate Metabolism; D018592:Cross-Over Studies; D004569:Electroencephalography; D002149:Energy Intake; D004734:Energy Metabolism / Q000502:physiology*; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D009043:Motor Activity; D010084:Oxidation-Reduction; D016037:Single-Blind Method; D012890:Sleep / Q000502:physiology*; D012895:Sleep, REM; D055815:Young Adult